MRS. CRYSTAL BELLE PHIPPS BLOOMFELDT


Address: 214 Autumn Hills Rd, Kelso, WA 98626-9018
Phone: 3603557658

MRS. CRYSTAL BELLE PHIPPS BLOOMFELDT (NPI# 1669033098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669033098
Entity Type Individual
Full Name MRS. CRYSTAL BELLE PHIPPS BLOOMFELDT
Practice Address 214 Autumn Hills Rd
Kelso
WA 98626-9018
Practice Telephone 3603557658
Mailing Telephone 3603557658
Enumeration Date 2019-06-26
Last Update Date 2019-06-26
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address 214 AUTUMN HILLS RD
City KELSO
State WA
Zip Code 98626-9018

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1447535737 Nichole Kathleen Allee Massage Therapist 109 Nw 1st St., Kelso, WA 98626 2011-10-18
1689991655 Zachariah Kramer Radiology 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 2010-04-29
1508007071 Robert Lee Blair Registered Nurse 119 Blackburn Lane, Kalama, WA 98626 2009-03-13
1942318829 Imholte & Anderson Pllc Dentist 409 West Main Street, Kelso, WA 98626 2006-08-29
1922088723 James Bevan Hollingsworth Pharmacist 204 S Pacific Ave, Kelso, WA 98626 2006-01-18
1972021087 Adreia Jenice Jessop Registered Nurse 300 Oak St, Kelso, WA 98626 2017-09-08
1023567310 Charlene Han Pharmacist 205 Three Rivers Dr, Kelso, WA 98626 2016-09-27
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1669022810 Shannon Dawkins Military Health Care Provider 2150 Thresher Ave, Silverdale, WA 98315-2103 2019-09-18
1649830779 Monica Yineman Military Health Care Provider 9812 Enchantment Ave Nw, Silverdale, WA 98383-8822 2019-06-20
1164992491 Michael Thomas Stevens Military Health Care Provider 100 Hospital Loop, Fairchild Afb, WA 99011 2018-11-29
1326521097 Elizabeth Nicole Sifuentes Military Health Care Provider Uss Michigan- Commander Sub Group Nine, 2150 Thresher Ave, Silverdale, WA 98315-2150 2018-09-10
1740710557 Randle Scott Groves Military Health Care Provider Psns&imf Det Everett, 2000 West Marine Drive, Bldg 2202, Everett, WA 98207 2017-06-14
1235599234 Corey Thacker Military Health Care Provider 1912 Nw Circle Dr N, Poulsbo, WA 98370-9527 2016-03-03
1679965222 Asher Abbott White Jr. Military Health Care Provider 8806 86th Ave Nw, Gig Harbor, WA 98332-6752 2015-02-19
1023414927 Larry Jones Military Health Care Provider 386 Nw Dory Dr, Oak Harbor, WA 98277-2077 2014-11-05
1598027237 Epafara Jeffrey Vaitautolu Military Health Care Provider 30 Wencker Way Apt A, Bremerton, WA 98312-1861 2012-06-08
1841595352 Brandon Alexander Martinfrazier Military Health Care Provider 610 Dowell St., Bldg. 6, Keyport, WA 98345 2011-01-13
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Competitor

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City KELSO
Zip Code 98626

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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